Taking a proactive, systematic approach to healthcare business continuity planning is essential in helping hospitals and health systems recover from a disruptive event with minimal impact to patients, employees, family members and stakeholders. This starts at the highest level of the healthcare organization. Engaged executive buy-in of business continuity planning has been identified as an essential element to its success. Developing a program that protects the health and safety of patients and staff and maintains critical clinical and operational functions requires a comprehensive and cross organizational planning effort that is sustained over time with not only executive buy-in – but active executive involvement. Executive buy-in is a critical component in optimizing the healthcare organizational resilience program across the enterprise. The business continuity management program must be both sanctioned and enforced with engaged contribution by the organization’s most senior leadership.